Overweight and obesity among children and youth in the United States is a serious public health concern. The longitudinal relationships between maternal depression and childhood overweight and obesity were examined using data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (NICHD SECCYD). A national cohort of 1,384 children was followed from birth to adolescence and longitudinal data collected on multiple variables, including child weight and height, maternal depression, maternal influence, and family context. Maternal Depression was assessed by the Center of Epidemiological Studies Depression Scale (CES-D) and defined as a score of 16 or greater. Overweight and obesity were defined according to the recommended BMI age- and sex-specific percentiles. Maternal depression was assessed when the child was 1 month old, 36 months, and in grade 1. Overweight and obesity status was assessed at 36 months, grade 1, grade 3, and grade 6. The effect of changes or persistence in the pattern of maternal depression for different childhood age points on the development of childhood overweight and obesity was evaluated. A variety of statistical methods were used including t-test, ANOVA, multiple linear regression, multiple logistic regression, and generalized estimation equation (GEE). Results: After adjustment for confounding, compared with mothers with no depression at child's age of 1 month, 36 months, and in grade 1, mothers with depression at 1 or 2 of those time points had a 45% higher risk for childhood overweight and obesity at grade 3 (OR= 1.45, 95% CI= 1.01-2.07). For mothers with depression at all 3 time points, there was an even greater increase in risk at grade 3 (OR= 2.25, 95% CI= 1.05-4.84) and grade 6 (OR= 3.36, 95% CI= 1.46-7.77). Conclusion: Maternal depression is associated with childhood overweight and obesity. Child overweight and obesity intervention efforts may benefit from identifying strategies to improve maternal mental health status, including depression.

This study examined the longitudinal associations of family income level, maternal marital status, and maternal employment with body mass measurements and the development of overweight and obesity. Multiple linear and logistic regressions were used to assess the effects of the exposure variables on weight status with simultaneous adjustment for the exposure variables and the covariates. Key findings include: Children in families with incomes below the poverty line at child's 24 or 54 months of age were at a higher risk of becoming overweight and obese at child's third grade than children in families with incomes above the poverty line; longer maternal working hours at child's 54 months of age was associated with an increased risk of overweight and obesity at child's third grade. In conclusion, this study confirms that family poverty status and maternal working hours are associated with child's overweight and obesity risk.

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Obesity is a public health concern and cardiometabolic consequences are severe when obesity develops during youth and continues into adulthood. Treatment prior to adulthood confers health benefits, but adolescent obesity rates have continually increased, reaching 20.6% in 2013-2014. Quality and quantity of dietary intake contribute to the development of obesity, but limitations of self-reported dietary intake are evident in overweight or obese adolescents, who frequently misreport nutrients of concern. Added sugar, sodium, and protein intake may indicate diet quality in this population. The 2015-2020 Dietary Guidelines recommend decreasing consumption of added sugars, sodium, and processed protein due to their known contributions to overweight and obesity. Objective dietary intake assessment measures are necessary for investigating the association between dietary intake and health outcomes. Added sugar, sodium, and protein intake could be assessed objectively with a panel of urinary biomarkers. Prior research indicates the potential of these urinary biomarkers to reflect dietary intake, but to date, no controlled feeding study has been conducted in adolescents. Using a controlled feeding design, the current study aims to evaluate the validity of urinary sucrose, fructose, sodium, and nitrogen as objective indicators of dietary intake. It is hypothesized that urinary sucrose and fructose will reflect dietary added sugar intake, while urinary sodium and nitrogen will correspond to dietary sodium and protein intake, respectively, in a healthy adolescent population. These biomarkers, if valid, could be used in clinical and epidemiological research to improve understanding of the associations between dietary intake and health outcomes. / Master of Science

Existing systematic reviews have suggested that cooking interventions can be beneficial for improving dietary intake and health outcomes, with research indicating that the ability to prepare meals at home may prove to be more complex, and involve influencing factors (i.e., cooking self-efficacy, food agency [i.e., one's ability to procure and prepare food with the considerations of their physical, social and economic environment], and nutritional literacy/knowledge) for improving health outcomes. With the average American's diet consisting of about 60% of total energy coming from the consumption of ultra-processed foods, interventions that target increasing cooking skills and the frequency of consuming home-cooked meals may help to reduce reliance on processed foods, improve dietary intake quality, and reduce risk of weight gain, obesity, and related conditions. To date, there are no systematic reviews that have addressed the impact of cooking interventions on processed or ultra-processed food consumption. Therefore, this research systematically reviewed the body of literature focused on cooking interventions and dietary intake including processed food consumption and evaluated intervention's effectiveness at improving dietary intake and physical and mental health outcomes. English and full-text research articles published through January 2021 were obtained through PubMed, CINAHL using EBSCO, Web of Science from Clarivate, Scopus and PsycInfo. Overall, 55 articles were obtained after meeting the inclusion criteria and going through the data extraction process. Outcomes of interests to measure included fruit and vegetable consumption, body mass index (BMI), body weight, waist circumference, blood pressure, physical activity, and if the study measured psychosocial outcomes or processed food consumption. Results indicate that when analyzing the effect sizes for studies that reported mean data for each group (eg, intervention and control/comparison groups), 86% of studies measuring fruit intake found a positive effect size (Average: Cohen's d: 0.65, 95% CI: 0.30, 0.99); 90% of studies measuring vegetable intake found a positive effect size (Average: Cohen's d: 0.80, 95% CI: 0.37, 1.09); 82% of studies measuring BMI found a negative effect size (Average: Cohen's d: -0.20, 95% CI: -0.58, 0.17); 100% of studies measuring body weight had a negative effect size (Average: Cohen's d: -0.27, 95% CI: -0.77, 0.23); and 100% of studies measuring waist circumference had a negative effect size (Cohen's d: -0.16, 95% CI: -0.60,0.24). This systematic review will provide information on recently published studies that were not incorporated in prior reviews that can be utilized in future interventions that aim to improve health outcomes and reduce processed food consumption. / Master of Science / Prior systematic reviews have stated that cooking classes and demonstrations may be beneficial for improving an individual's diet and overall health. Research currently suggests that the ability to prepare meals at home may prove to be more difficult to assess, and involve other factors, (i.e., cooking confidence, one's ability to get and prepare food in their physical, social and economic environment, and nutritional knowledge) for improving physical and mental health. With the average American's diet consisting of about 60% of total energy coming from the consumption of ultra-processed foods, interventions that aim to improve cooking skills and how often someone consumes home-cooked meals may help to reduce reliance on processed foods, improve diet quality, and reduce risk of weight gain, obesity, and related conditions. To date, there are no systematic reviews that have explored cooking interventions effects on ultra-processed food consumption. This research systematically reviewed the body of literature focused on cooking interventions and dietary intake including processed food consumption and evaluated their effectiveness at improving dietary intake and physical and mental health outcomes. English and full-text research articles published through January 2021 were obtained through five online databases. Overall, 55 articles were included. Outcomes of interests included fruit and vegetable consumption, body mass index (BMI), body weight, waist circumference, blood pressure, physical activity, psychosocial outcomes, and processed food consumption. Results indicate that 86% of studies measuring fruit intake found their intervention to be effective in increasing fruit intake. A total of 90% of studies measuring vegetable intake found that their interventions were effective at improving vegetable intake. 82% of studies measuring BMI found that their interventions showed effectiveness at decreasing BMI. Both 100% of studies measuring body weight and waist circumference showed effectiveness at decreasing both measures. This systematic review will provide information on recently published studies that were not incorporated in prior reviews that can be utilized in future interventions that aim to improve health outcomes and reduce processed food consumption.

The prevalence of children and adolescents who are considered overweight or obese has grown drastically in the United States. Childhood overweight and obesity is associated with serious long-term health consequences, including an increased risk for cardiovascular disease, type 2 diabetes, strokes, and different types of cancers. Added sugar intake (AS), in the form of sugar-sweetened beverages (SSB), may contribute to weight gain and obesity development in children and adolescents. Due to the negative health implications of SSB consumption, a valid and reliable brief beverage intake assessment tool is needed for children and adolescents to advance research in this area. The BEVQ-15 food frequency questionnaire has been validated as a tool to assess habitual beverage intake in adults. By validating this tool in youth, there will be a rapid, feasibly administered method to assess beverage intake in children and adolescents. The purpose of this investigation was to determine the comparative validity and test-retest reliability of the BEVQ-15 for assessing usual beverage intake in children and adolescents. Participants (n=326) completed four laboratory sessions, which included providing demographic information, assessment of height/weight, and four record-assisted 24 hour dietary recalls (24HR) from January 2014-September 2015. The BEVQ was completed at 2 sessions (BEVQ1, BEVQ2). Validity was assessed by comparing beverage intake from dietary recalls (24HR) to the BEVQ1; reliability was assessed by comparing BEVQ responses at two sessions (BEVQ1, BEVQ2). Data analysis included descriptive statistics, paired sample t-tests, independent sample t-tests, and chi-squared test, and one-way ANOVA tests. Comparisons of validity and reliability were also made within two subsets; children (aged 6-11) and adolescents (aged 12-18). In the full sample, self-reported water and total sugar-sweetened beverage intake (in fl oz and kcal) were not different between BEVQ1 and 24HR. Responses between BEVQ1 and BEVQ2 were not different in intake (fl oz) or energy (kcal) for water, milk, and total sugar-sweetened beverages. In children, milk and energy (kcal) for total beverages were not different between BEVQ1 and 24HR. No differences were reported between BEVQ1 and BEVQ2 across beverage categories. In adolescents, water and energy (kcal) for total-sugar sweetened beverages were not different between BEVQ1 and 24HR. No differences were reported between BEVQ1 and BEVQ2 with the exception of sweetened juice drinks and total beverages. Overall, these results demonstrate that the BEVQ-15 appears to be a valid and reliable tool to assess habitual water and total SSB intake in children and adolescents. This tool could further epidemiological and clinical research examining the impact of SSB intake, as well as intake of other beverages, on health. / Master of Science

An estimated 20.5% of adolescents ages 12 – 19 years were obese (≥95th percentile of BMI-for-age) in 2011 – 2014. Consumption of added sugars (AS) has been linked with adverse effects on weight and cardiovascular disease risk factors. Approximately 16% of adolescents’ calories come from AS, of which sugar-sweetened beverages (SSB) are a major contributor. However, the relationship between AS/SSB intake and obesity is controversial, partly due to limitations in self-reported dietary data. Objective dietary intake biomarkers may circumvent this problem. The δ13C biomarker for AS intake is based upon the fact that C4 plants– major source for sugar production in the United States – have elevated δ¹³C values compared to C3 plants, which includes most fruits and vegetables. The δ¹³C value of blood, which is influenced by diet, has been established as a valid, reliable, and sensitive biomarker, but when compared to selfreported AS intake. This investigation evaluated the sensitivity and reliability of the δ13C biomarker, assessed with fingerstick blood samples, in adolescents using a controlled feeding, crossover design. Fingerstick δ¹³C values significantly changed by -0.05‰ and +0.03‰ after subjects completed the 5% and 25% AS diets, respectively (F(1, 30) = 18.828, p < 0.001). High reliability was found between two consecutive fingerstick δ¹³C values on the low (ICC = 0.996) and high (ICC = 0.997) AS diets. Thus, fingerstick δ¹³C may be a sensitive and reliable indicator of AS intake in adolescents. Future investigations should develop an equation to estimate AS intake based on fingerstick δ¹³C / Master of Science

Övervikt och fetma är ett folkhälsoproblem som ökar i en oroväckande takt både i Sverige och i många andra delar av världen. Fetma räknas som en sjukdom i sig, men är även en riskfaktor för andra icke smittsamma sjukdomar. Våra levnadsvanor grundläggs redan under barndomen och inverkar på hälsan resten av livet. Att satsa på förebyggande åtgärder i tidig ålder kan således vara viktigt för att minska risken att barn senare i livet drabbas av överviktsrelaterade sjukdomar. Syftet med denna studie var att undersöka skolsköterskors och skolors erfarenheter av och förutsättningar för att arbeta med övervikt och fetma bland barn mellan sex och elva år. För att besvara syftet användes en kvalitativ metodansats. Totalt genomfördes sex enskilda semistrukturerade intervjuer med skolsköterskor. Intervjuerna analyserades med en manifest innehållsanalys. I resultatet framkom att övervikt och fetma är vanligt förekommande på skolorna. Övervikt och fetma anses vara ett viktigt, men också svårt, område för skolor att arbeta mot. Skolsköterskorna uppfattar flera hinder i sitt arbete, och önskar att de kunde göra mera för att hjälpa barn som drabbats. Skolsköterskorna har många idéer om hur de och skolorna skulle kunna arbeta förebyggande, men upplever en frustration över de bristande resurserna som ges till det. / Overweight and obesity is a public health problem that is increasing in an alarming rate both in Sweden and in many other parts of the world. Obesity is considered as a disease in itself, but is also a risk factor for other noncommunicable diseases. Our habits are established during childhood and have an impact on our health throughout our lives. Investing in preventive interventions at an early age may therefore be important for reducing the risk of children later in life suffer from obesity-related diseases. The aim of this study was to examine school nurses' and schools’ experiences of and presumptions for working with overweight and obesity among children at primary schools. A qualitative approach was chosen and a total of six individual semi-structured interviews with school nurses were conducted. The interviews were analysed with a manifest content analysis. The result showed that overweight and obesity are common in the primary schools. Overweight and obesity are considered an important, but also difficult, area for schools to work against. The school nurses perceive several obstacles in their work, and wish they could do more to help children who are affected. The school nurses have many ideas about how they and the schools could work preventive, but are frustrated over the lack of resources that are given to it.

Title: The use of walk to reduce overweight and obesity in middle-aged women Aims: The aim is to assess the exercise regimen and assess the impact of changes in body composition by using the walk on for middle-aged women with overweight and obesity Methods: File under consideration formed 16 women aged 30 to 60 years of age, have passed the basic course on reducing the weight of STOB and at the same time engage in the study of MUDr. Marie Skalská, where specifically increase their physical activity by walking. In the framework of this thesis I investigated the influence of these interventions to change their body composition and daily routine. The measurement of body composition by bioelectrical impedance after the physical intervention on the duration of 20 weeks. Daily exercise regimen was measured by pedometers in the course of the intervention with a length of 20 weeks. The effect of the intervention was evaluated using the survey of physical activity, which was submitted before and after the intervention. Results: Physical intervention based on the walking has affected body composition middle-aged women with overweight and obesity. An average weight reduction of 3.2 kg. BMI decreased by 1,1 kg m-2 . The circumference of the waist has shrunk by 3.5 cm and the percentage of fat in the body is...